JP5318541B2 - Positioning device for low birth weight or premature infants - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a positioning tool for low-birth-weight babies or premature babies which is useful for standardizing a positioning tool, prevents a wrong position, enhances a sense of security and comfort for children, and is useful for preventing the deformity of joints. <P>SOLUTION: The positioning tool for low-birth-weight babies or premature babies is equipped with a T-shaped, a laying low rebound resilience mat (1), a surrounding low rebound resilience mat (2) having elasticity of a low rebound resilience, and a cylindrical soft towel (3) disposed to surround the mat (2) and the mat (1). The mat (1) has a head region rest (1a) and a chest region rest (1b). When the mat (2) is bent into a U shape to surround, both ends (2a, 2a) are positioned in the vicinity of both shoulders of the child, and concavities and convexities (2c) of the low rebound resilience are formed on the inner wall surface (2b) with which feet make contact. <P>COPYRIGHT: (C)2010,JPO&amp;INPIT

Description

The present invention can not be growing in the maternal maturity, immature state, children is called low birth weight infants born as a premature infant, in particular weighing less than 1,800 grams less than or 28 weeks 600 g The present invention relates to a positioning device that can be applied to a very low birth weight infant or a very premature infant.

Positioning is one type of care that removes factors that hinder growth promotion for premature and sick children, protects against over-stimulation, and promotes neurobehavioral development.
FIG. 6 is a classification of “low birth weight infants and preterm infants” of children born in an immature state for which the positioning device of the present invention is used. Also includes “birth”. As shown in this figure, “super low birth weight infant” means a child whose birth weight is less than 1,000 g, and “super premature infant” means a child born by the 28th week of pregnancy (version). .
FIG. 7 is a perspective view of a conventionally used “low birth weight infant or premature infant”, in particular, “very low birth weight infant or very premature infant”, and a towel 12 laid under the child. It is. As shown in this figure, at the Maternal and Child Health General Medical Center to which the present invention belongs, the entire circumference of the child M is surrounded in a form in which a towel is formed in a cylindrical shape and the height of the box is slightly hammocked. A method of raising a child in a NICU (neonatal intensive care unit) 11 has been performed.

  According to the above method, (a) the entire circumference of the enclosure is covered with cloth so that the circumference of the enclosure does not shift, (b) and the child's positioning can be maintained without fixing the surrounding article itself. (C) The head is stable and there is no gap between the floor and the enclosure, and the foot movement is bounded and the entire body is not displaced easily. (D) Kicking (foot) Kick) is easy to be promoted, it is elastic to some extent regardless of where the child comes in contact, and does not interfere with flexor movement. (E) It is not fixed but emphasizes voluntary movement and moves to its original posture It has features such as being able to return.

  Also, in prone position, (a) height from face to front chest with face towel, etc., take a position to hold the thigh without abducting the hip joint, reduce abdominal pressure, (b) diaper cover It is necessary to pay attention to the width and size of the diaper, and (c) strives to maintain a good limb position (the correct position of the midline position of the joint of the limbs) so that the sole of the foot is perpendicular to the enclosure, ( d) Kicking the enclosure with the sole of the foot, extending the lower limbs, raising the buttocks, returning to the original posture later, and being able to calm down, (e) The trunk in the prone position (from the shoulder It has the features that it does not hinder the automatic movement (to the buttocks), prevents the trunk from being distorted by raising the height of the enclosure, and promotes the recognition of the midline even when holding the prone position.

  Other “low-birth-weight and premature infants” positioning tools include cotton / polyester / polyester blends that are modeled on the uterus and can be used to reassure and calm children. A type that can return to its original posture even if it moves actively (hereinafter referred to as Type 1), and a low-resilience urethane cushion covered with a cotton / polyester / polyester blended fabric cover. It is placed on the lower side when standing, and it makes the prone position naturally bent, which prevents abnormal postures and promotes the development of neurobehavior (hereinafter referred to as type 2), made of urethane It can be bent into a rectangular enclosure (with core material), can be bent freely, can hold its shape firmly, and can support various postures such as sideways and supine ( In the following, type 3) is proposed.

  As an incubator mat device that can make newborns feel at ease, prevent bed slipping, prevent crying at night, etc., and is easy to maintain, electric and mechanical vibrators are embedded in the pad, and audio signals Incubator mat device equipped with an equalizer that can correct the frequency characteristics of the sound signal generated by the generator to a characteristic close to the original frequency characteristics even if the sound is reflected and interferes in the incubator Has been proposed. However, this document is not particularly developed for low birth weight infants or premature infants (Reference 1).

  Japanese Patent Application Laid-Open No. 9-206343

  As mentioned above, the positioning devices used at our Maternal and Child Medical Center used a towel material to surround the entire circumference of the child, but low birth weight infants and premature infants (very low birth and ultra low birth In some cases (including premature infants), the material was hard with a towel, and there were several cases in which the ankle joint was hyperflexed, and the material had to be examined. In addition, the size of the towel material used in the prone position depends on individual judgment, and if the person in charge changes, the difference in preparation will cause a difference in care provision. There was no clear provision of care. As a result, the size of the enclosure is too large or too small, the length of the bedding is too long or too short, the width is too wide or too narrow, it does not fit the individual child, and it may cause a bad limb position It was. For this reason, it was necessary to provide a size with a clear basis and ensure the provision of care suitable for each child. In addition, there are no standardized positioning techniques in NICU (neonatal intensive care unit) facilities throughout the country, and various ingenuities and studies have been made for each facility. Therefore, it was necessary to examine specific tools and issues through the reactions of low-birth and premature babies (including very low-birth and super-premature babies).

  In addition, in each type 1 described in paragraph [0005] above, there is no body area of the head, so it is likely to be displaced upward, and the possibility of unplanned extubation while wearing a ventilator increases. There is. For Type 2, the trunk is wide and the child tends to hinder the action of bringing his hand to the mouth. Further, when the lower limbs extend, they cannot return to the original flexion position and promote self-sedation. There is a problem that can not be. Since the core of Type 3 contains a core material, the core part may come into contact with the child, and it is necessary to examine it from the viewpoint of ensuring safety and comfort.

The present invention has been made in order to address the various problems described above, and is useful for standardizing positioning devices, is unlikely to be in a poor limb position, is improved in safety and comfort for children, and is subject to excessive bending of the lower limbs. It is an object of the present invention to provide a positioning device for low birth weight infants or premature infants that is useful for preventing joint deformation and applicable to very low birth weights or premature infants.

    According to the first aspect of the present invention, the positioning device for a low birth weight infant or a premature infant is placed on a head inclined upward and downward when the head of a low birth weight infant is placed in the prone position. Floor rebound mat consisting of a head mounting part having a front part and a front chest mounting part for placing a front chest part, and a front chest mounting part narrower than this, and both ends when bent and enclosed in a substantially U shape The enclosure has a low-resilience mat for the enclosure that is located near the shoulders of the child and the inner wall surface that contacts the foot has low-elasticity elasticity, and a cylindrical towel around the head from both ends of the low-resilience mat for the enclosure It is characterized by.

According to a second aspect of the present invention, when the positioning device for low birth weight infants or premature infants takes the force of the child's foot on the inner wall surface of the surrounding low-resilience mat for contact, The unevenness which returns to the original position by the repulsive force of the mat is formed.

    According to a third aspect of the present invention, a positioning device for a low birth weight infant or a premature infant has a head mounting portion on which the head of the low-resilience mat for flooring is placed, and the head of the low-resilience mat for flooring is placed. The head mounting portion of the low-resilience mat for flooring composed of a narrower front chest mounting portion is provided with a notch on the lower side (back side) so that the head tilts downward. The positioning tool according to claim 1 or 2 is characterized in that it is a positioning tool.

According to a fourth aspect of the present invention, there is provided a positioning tool for low birth weight infants or premature infants, wherein the vertical and horizontal dimensions of the head mounting portion and the vertical and horizontal dimensions of the chest mounting portion of the low-resilience mat for flooring are provided. And the size of the surrounding low-resilience mat may be changed to less than 600 g, 600 to 1200 g, 1200 to 1800 g, or 1800 g or more depending on the size of the child's low birth weight infant or premature infant, respectively. A positioning tool for low birth weight infants or premature infants according to any one of claims 1 to 3.

  The positioning tool for low birth weight infants and premature infants according to the present invention is a positioning tool suitable for low birth weight infants and premature infants, particularly very low birth weight infants and very premature infants. If it can be disseminated nationwide (widely), it will help to study the standardization (unification) of positioning technology for very low birth weight infants and very preterm infants. Furthermore, it will lead to a quality improvement in the provision of nursing skills throughout the NICU (neonatal intensive care unit), and will also be a material for examining differences between facilities. Moreover, according to this invention, it becomes difficult to become a bad limb position, stabilization can be expected, and it leads also to prevention of unplanned extubation. Furthermore, the use of mats with low resilience, high density, high resilience, and low resilience for laying and surroundings will improve the comfort of extremely low birth weight infants and very premature infants, and it is expected to stabilize sleep wakefulness. It also leads to the provision of care that encourages the pursuit of comfort and development. Further, the pursuit of the elasticity of the tool leads to prevention of joint deformation such as lower limb hyperflexion of very low birth weight infants and extremely premature infants.

Hereinafter, specific embodiments of the present invention will be described with reference to the drawings.
FIG. 1 is a perspective view showing a layout of a positioning tool for low birth weight infants and premature infants according to the present invention, with a sheet covering the whole being removed.
The positioning tool for a low birth weight infant or a premature infant includes a floor low-resilience mat 1 including a head placement portion and a narrower front chest placement portion , a surrounding low-resilience mat 2, and the enclosure And a cylindrical flexible towel 3 arranged so as to surround the low-resilience mat 1 for flooring from both ends of the bottom rebound mat 2 for use around the head.

FIG. 2 (A) is a plan view showing the shape of a low-resilience mat for laying composed of the head mounting portion and a narrower front chest mounting portion, and FIG. 2 (B) is a side view. . The floor low-resilience mat 1 composed of the head placement portion and the narrower front chest placement portion has a slightly horizontally long head placement portion 1a on which the child's head is placed, and the child's front chest ( It is formed of a vertically long front chest placing portion 1b having a uniform thickness from the shoulder to the lower front of the rib. Further, when the enclosure low-resilience mat 2 is bent and surrounded, both end portions (2a, 2a) are positioned in the vicinity of both shoulders of the child and the inner wall surface 2b in contact with the foot has low-repulsion elasticity. For example, irregularities 2c, 2c,... Are formed.

As shown in FIGS. 1 and 2, the horizontally long head placing portion 1a of the low-resilience mat 1 for laying composed of the head placing portion and the narrow front chest placing portion is a vertically long front chest portion. The width is larger than the mounting portion 1b. This is because the head width may not be stable with the width of the head that is the same as the width of the conventional front chest, and it may slip off from the low-resilience mat 1 for flooring. The width of the mounting portion 1a was made larger than the vertically long front chest mounting portion 1b as the width of the head.

The length and width of the head placement portion 1a of the low-resilience mat 1 for laying are such that the child's head is oriented sideways, and the length and width of the front chest placement portion 1b is The width of the trunk (from the shoulder to the buttocks) and the trunk (from the neck to the bottom of the rib) and the width (excluding the arms) were measured and created from the average value. The thickness of the low-resilience mat 1 for laying is created using the position of the abdomen as a guide when the lower limb is bent. In this case, the trunk could be supported by the entire front chest and there was no pressure on the abdomen.
A cutout 1c is provided on the lower side of the head mounting portion 1a of the low-resilience mat 1 for flooring. The notch 1c is a device for inclining the head placing portion 1a upward and downward when the child's head is placed. That is, if the height of the front chest mounting portion 1b and the head mounting portion 1a of the low-resilience mat for laying is the same, it is easy to bend backward or forward from the neck to the head. Therefore, the height of the head placement portion 1a under the head is basically ½ of the height of the bedcloth of the front chest placement portion 1b under the front chest when a conventional towel is used. Since it was unclear how the low-resilience mat was low-resilience and the pressure applied by the child's weight, it was created as 2/3 of the height of the bed under the head. When such a notch 1c is provided, the tilted angle prevents the rearward bending position and the forward bending position. In the case of a child under 600 g, it is created as 1/2 the height of the bedcloth under the front chest.

  In addition, the notch 1c, which makes a difference in the height of the head and front chest, was provided on the lower side, so that the contact surface of the child had a more natural inclination.

  Next, as shown in FIG. 3, the length of the surrounding low-resilience mat 2 when it is not bent is such that both ends (2a, 2a) come to the positions of both shoulders of the child when bent into a substantially U shape. The length was considered so as not to affect the endotracheal intubation tube (not shown). In this case, the position of the endotracheal intubation tube could be maintained at the midline and there was no displacement. The overall length of the enclosure can be adjusted with a cylindrical flexible towel 3 arranged to surround the head on the head side. When the encircling low-resilience mat 2 is bent into a substantially U-shape and surrounded by a large number of irregularities 2c, 2c,... It is used as a means of low repulsion, but it returns to its original position when the child's feet are used. Therefore, as shown in FIG. 4, there is no deformation of the ankle joint of the foot L of the child M, the sole is vertically enclosed, hits the inner wall of the low-resilience mat 2 and maintains a good limb position (normal joint position state). can do.

The standard of shoulder to shoulder of the surrounding low-resilience mat 2 is about 1500 g. Children over 1800g are rarely managed in prone position during artificial ventilation and are usually managed in supine position. In supine position, adjust the length of towel 3 around the head according to the child, and do not adapt to shoulder-to-shoulder guidelines. That is, the low-resilience mat 1 for laying composed of the head mounting portion 1a and the front chest mounting portion 1b narrower than this is used only in the prone position. The U-shaped low-resilience mat 2 for enclosure is not used as a measure of shoulder-to-shoulder. In the case of the supine position and the prone position of 1500 g or more, the overall size is adjusted with the towel 3 on the head.

  As will be described later, the surrounding low-resilience mat 2 has two types of height. In the prone position, it matches the height of the back and can maintain the stability of the trunk. In other words, even if the trunk of the child moves, it will contact the surrounding low-resilience mat and recognize the body boundary area. In addition, it is thought that it is also contributing to the self-sedation behavior of returning to the original position. And, if the low-resilience mat 1 for laying was correctly positioned on the head and front chest, there was no hindrance to the operation of bringing the hand to the mouth. In addition, trunk stability was observed in all cases.

  As shown in FIG. 1, the cylindrical flexible towel 3 is arranged so as to surround the low-resilience mat 1 around the head from both ends of the low-resilience mat 2 for the enclosure. The tubular flexible towel 3 serves to adjust the overall length of the enclosure.

{Specific examples}
FIG. 5 is a diagram showing an example of dimensions according to body weight of the low-resilience mat 1 for laying and the low-resilience mat 2 for surrounding in the embodiment of the positioning tool for low birth weight infants and premature infants of the present invention. In this case, the floor low-resilience mat 1 measures the lateral and longitudinal dimensions of the child's head, measures the width of the trunk from the neck to the lower rib, According to the size of the low birth weight infant, the body weight was prepared according to the body weight of less than 600 g, 600 to 1200 g, 1200 to 1800 g, 1800 g or more. Specifically, four types of low resilience mats 1 for flooring were prepared.
As one of them, the weight of the child is less than 600 g, the size of the head mounting portion 1a is 7 cm wide, 6 cm long, 1.5 cm thick excluding the notch 1c, and the front chest mounting portion 1b is 5 horizontal. The thickness was 5 cm and the thickness was 3 cm.
Second, the weight of the child is 600-1200 g, the dimensions of the head placement part 1a are 8 cm wide, 7 cm long, 2 cm thick excluding the notch 1c, and the front chest placement part 1b is 6 cm wide. The thickness was 3 cm.
Third, the weight of the child is for 1200 to 1800 g, the dimensions of the head mounting part 1a are 9 cm wide, 8 cm long, 2.3 cm thick excluding the notch 1c, and the front chest mounting part 1b is horizontal. The thickness was 7 cm, length 7 cm, and thickness 3.5 cm.
As the fourth, for the child's weight of 1800 g or more, the dimensions of the head placement portion 1a were 10 cm wide, 8 cm long, and 4 cm thick.

Moreover, the said low-resilience mat 2 for enclosure was also produced with the following dimension. Measured in a substantially U-shape, the first is that the child's weight is less than 600 g, the length is 45 cm along the U-shape, the width of the vertical part that constitutes each U-shape is 6 cm, and the thickness is 6 cm. Was 7 cm.
Secondly, when the weight of the child is 600-1200g, the length along the U-shaped state is 50cm, the width of the vertically long part constituting each U-shape is 6cm, the thickness is 7cm, and the distance is 7-8cm did.
Third, when the weight of the child is 1200 to 1800 g, the length along the U-shaped state is 50 cm, the width of the vertically long part constituting each U-shape is 6 cm, the thickness is 7 cm, and the distance is 8-9 cm did.
As the fourth, when the weight of the child is 1800g or more, the length along the U-shape is 50 cm, the width of the vertically long part constituting each U-shape is 6 cm, the thickness is 7 cm, and the distance is 9-10 cm .
The enclosure low-resilience mat 2 has two types of height. Actually, the floor low-resilience mat 1 or the enclosure low-resilience mat 2 depends on the growth situation such as the weight and height of the child. In consideration of the above dimensions, the dimensions can be changed to several types according to the size of the child.

  Further, as the material of the floor low-resilience mat 1, the surrounding low-resilience mat 2, and the cylindrical flexible towel 3, a foaming agent such as soft cotton, urethane, or polyolefin is suitable. That is, a material that can be elastic so that it returns to its original state when the force is removed even if the child kicks or pushes the inner wall of the surrounding low-resilience mat 2 with a foot is used. Note that soft cotton is suitable for the tubular flexible towel 3.

FIG. 1 is a perspective view showing the arrangement of a positioning tool for a low birth weight infant or a premature infant according to the present invention, with a sheet covering the whole being removed. FIG. 2 (A) is a plan view showing the shape of the low-resilience mat for laying of the low-resilience mat for laying composed of a head mounting portion and a narrower front chest mounting portion , and FIG. It is a side view. A low rebound mat for a floor and a low for enclosure of a low rebound mat for a floor composed of a head placement portion and a narrower front chest placement portion constituting a positioning tool for low birth weight infants or premature infants of the present invention It is a perspective view of a low resilience mat part. FIG. 3 is a perspective view of a buttock and a leg portion in a state where a child is placed on a positioning tool for a low birth weight infant or a premature infant according to the present invention. It is a figure which shows the dimension example according to the body weight of the low-resilience mat for floor | beds in the said embodiment of the positioning tool of the low birth weight infant or the premature infant of this invention, and the low-resilience mat for enclosure. FIG. 4 is a classification diagram of “low birth weight infants and premature infants” of children born in an immature state as a target for using the positioning device of the present invention. It is a perspective view which shows the use condition of the positioning tool in the NICU (neonatal intensive care unit) for neonates conventionally used as positioning of a low birth weight infant and a premature infant.

1 floor low-resilience mat 1a Head placement 1b Fore chest placement 1c Notch 2 Enclosure low-resilience mat 2a Enclosure low-resilience mat 2b Enclosure low-resilience mat
2c Enclosure memory foam mat
3 Flexible towel on the tube

Claims (4)

When the head of the child of a low birth weight infant is placed in the prone position, the head placement portion having a head placement portion that is inclined upward and downward and a front chest placement portion for placing the front chest portion, and from this A low-resilience mat for flooring composed of a narrow front chest placement part, and when bent and enclosed in a substantially U shape, both ends are located near the child's shoulders and the inner wall surface where the foot contacts is low-elasticity elasticity A low birth weight mat for a low birth weight or a premature baby comprising a low resilience mat for enclosure and a cylindrical towel around the head from both ends of the low foam mat for enclosure. The inner wall surface with which the foot of the surrounding low-resilience mat comes into contact is formed with irregularities that return to the original position by the repulsive force of the surrounding low-resilience mat when the force of the child's foot is taken. Item 2. A positioning tool for low birth weight infants or premature infants according to Item 1. The head mounting part of the flooring low-resilience mat, which includes the head mounting part for placing the head of the flooring low-resilience mat and the front chest mounting part narrower than this, has a head inclined downward. The positioning tool for low birth weight infants or premature infants according to claim 1 or 2, wherein a notch is provided on the lower side (back side). The vertical and horizontal dimensions of the head mounting portion of the foam low-resilience mat, the vertical and horizontal dimensions of the chest mounting portion, and the dimensions of the surrounding low-resilience mat are as follows: The positioning device according to any one of claims 1 to 3, wherein the positioning device is divided into less than 600 g, 600 to 1200 g, 1200 to 1800 g, and 1800 g or more according to the size of each.

Images